Organization Active NPI

Jackson Center Rescue Squad Inc

  • Land Ambulance
  • Jackson Center, OH
National Provider Identifier
1285635060
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
JACKSON CENTER RESCUE SQUAD INC
Practice address
523 N Main
Jackson Center, OH 45334
Phone
(937) 596-6640
Fax
(937) 596-6640
NPI assigned
Aug 3, 2005
Last updated
Mar 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jill Ludwig
Title
President
Phone
(937) 658-0006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X NU Primary

Addresses

Primary practice location

523 N Main
Jackson Center, OH 45334

Mailing address

PO Box 4
Jackson Center, OH 45334-0004
Phone (937) 596-6640

Other identifiers 3

IdentifierTypeStateIssuer
000000006165OtherOHANTHEM
0417712MedicaidOH
590009255OtherOHRAILROAD MEDICARE

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268352000000",
    "number": "1285635060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4",
            "city": "JACKSON CENTER",
            "state": "OH",
            "postal_code": "453340004",
            "telephone_number": "937-596-6640",
            "fax_number": "937-596-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 N MAIN",
            "city": "JACKSON CENTER",
            "state": "OH",
            "postal_code": "45334",
            "telephone_number": "937-596-6640",
            "fax_number": "937-596-6640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON CENTER RESCUE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2010-03-12",
        "status": "A",
        "authorized_official_last_name": "LUDWIG",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-658-0006"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000006165",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0417712",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590009255",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Center, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.